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CHA56107-100821I Adv Sol H61540H8889 Grph889-801 MINNESOTA MEDICA ADVANTAGE SOLUTION® (HMO-POS) MEDICA GROUP ADVANTAGE SOLUTIONSM (PPO) MEDICA ADVANTAGE SOLUTION® (PPO) 2021 PROVIDER DIRECTORY Minnesota Service Area (Twin Cities Metro, Greater Twin Cities Metro and Greater Minnesota) Counties: Anoka, Becker, Beltrami, Benton, Blue Earth, Brown, Cass, Carver, Chisago, Clay, Clearwater, Crow Wing, Dakota, Douglas, Grant, Hennepin, Hubbard, Isanti, Kandiyohi, Mahnomen, Morrison, Norman, Otter Tail, Pope, Ramsey, Scott, Sherburne, Stearns, Todd, Wadena, Washington, Wilkin and Wright Y0088_56107_C Discrimination is Against the Law Medica complies with applicable Federal civil rights laws and will not discriminate against any person based on his or her race, color, creed, religion, national origin, sex, gender, gender identity, health status including mental and physical medical conditions, marital status, familial status, status with regard to public assistance, disability, sexual orientation, age, political beliefs, membership or activity in a local commission, or any other classification protected by law. Medica: • Provides free aids and services to people with disabilities to communicate effectively with us, such as: TTYcommunication • Written information in other formats (large print, audio, other formats) • Provides free language services to people whose primary language is not English, such as: Qualified interpreters and information written in other languages If you need these services, contact the number on the back of your identification card. If you believe that Medica has failed to provide these services or discriminated in another way on the basis of your race, color, creed, religion, national origin, sex, gender, gender identity, health status including mental and physical medical conditions, marital status, familial status, status with regard to public assistance, disability, sexual orientation, age, political beliefs, membership or activity in a local commission, or any other classification protected by law, you can file a grievance with: Civil Rights Coordinator, Mail Route CP250, PO Box 9310, Minneapolis, MN 55443-9310, 952-992-3422, TTY: 711, [email protected]. You can file a grievance in person or by mail, fax, or email. You may also contact the Civil Rights Coordinator if you need assistance with filing a complaint. You can also file a civil rights complaint with the U.S. Department of Health and Human Services, Office for Civil Rights, electronically through the Office for Civil Rights Complaint Portal, available at https://ocrportal.hhs.gov/ocr/portal/lobby.jsf or by mail or phone at: U.S. Department of Health and Human Services, 200 Independence Avenue, SW Room 509F, HHH Building, Washington, D.C. 20201 800-368-1019, 800-537-7697 (TDD). Complaint forms are available at http://www.hhs.gov/ocr/office/file/index.html. If you want free help translating this information, call the number included in this document or on the back of your Medica ID card. Si desea asistencia gratuita para traducir esta información, llame al número que figura en este 이 정보를 번역하는 데 무료로 Medica 도움을 받고ID 싶으시면 , documento o en la parte posterior de su tarjeta de 이 문서에 포함된 전화번호나 카드 뒷면의 identificación de Medica. 전화번호로 전화하십시오. Si vous voulez une assistance gratuite pour traduire Yog koj xav tau kev pab dawb kom txhais daim ces informations, appelez le numéro indiqué dans ntawv no, hu rau tus xov tooj nyob hauv daim ntawv ce document ou au dos de votre carte d’identification no los yog nyob nraum qab ntawm koj daim npav Medica. Medica ID. erh>tJ.’d;w>usd;xHpXRuvDM>eRw>*h>w>usdRtHRvXtuvDM. <ud;vDwJpdeD.*H>vXty.CkmvXvHmwDvHmrDtylRtHRrhwrh>zJe 如果您需要免費翻譯此資訊，請致電本文檔中或者Medica ID 在您的 卡背面包含的號碼。 Medica vHmtk.o;c;uhtvD>cHwuyRtzDcd.M.wuh>I Nếu quý vị muốn trợ giúp dịch thông tin này miễn phí, Kung nais mo ng libreng tulong sa pagsasalin ng hãy gọi vào số có trong tài liệu này hoặc ở mặt sau thẻ ID impormasyong ito, tawagan ang numero na kasama Medica của quý vị. sa dokumentong ito o sa likod ng iyong Kard ng Odeeffannoo kana gargaarsa tolaan akka isinii Medica. hiikamu yoo barbaaddan, lakkoobsa barruu kana ይህን መረጃ ለመተርጎም ነጻ እርዳታ የሚፈልጉ ከሆነ በዝ ህ ሰነድ ዉስጥ keessatti argamu ykn ka dugda kaardii Waraqaa ያለውን ቁጥር ወይም Medica መታወቅያ ካርድዎ በስተጀርባ ያለውን Eenyummaa Medica irra jiruun bilbila’a. ይደውሉ። Ako želite besplatnu pomoć za prijevod ovih إذا كنت تريد مساعدة مجانية في ترجمة هذه المعلومات، فاتصل على الرقم الوارد في هذه الوثيقة أو على ظهر informacija, nazovite broj naveden u ovom .dokumentu ili na poleđini svoje ID kartice Medica بطاقة تعريف ميديكا الخاصة بك. Если Вы хотите получить бесплатную помощь в переводе этой информации, позвоните D77 t’11 j77k’e sh1 ata’ hodoonih n7n7zingo 47 ninaaltsoos по номеру телефона, указанному в данном Medica bee n47ho’d7lzin7g7 bine’d44’ n1mboo bik7‘1g78j8’ документе и на обратной стороне Вашей b44sh bee hod7ilnih. индентификационной карты Medica. Wenn Sie bei der Übersetzung dieser Informationen ຖ້າທ່ານຕ ້ອງການຄວາມຊ ່ວຍເຫ ຼືອໃນການແປຂ ໍ້ມູນນ ີ້ຟຣ ,ີ ໃຫ ້ kostenlose Hilfe in Anspruch nehmen möchten, ໂທຫາເລກໝາຍທີ່ມີຢ ູ່ໃນເອກະສານນີ້ ຫ ຼື ຢດູ່ ້ານຫຼ ັງຂອງບັດ rufen Sie bitte die in diesem Dokument oder auf Medica ຂອງທ່ານ. der Rückseite Ihrer Medica-ID-Karte angegebene Nummer an. MCR-0119-F ® Medica Advantage Solution (HMO-POS), Medica Advantag e Solution® (PPO) and Medica Group Advantage Solution SM (PPO) Provider Directory This directory is current as of September 17, 2021. This directory provides a list of Medica Advantage Solution (HMO-POS), Medica Advantage Solution (PPO) and Medica Group Advantage Solution (PPO) current network providers. This directory is for the Medica Advantage Solution (HMO-POS) and Medica Advantage Solution (PPO) service area in the counties listed below. You may go to any of our network providers listed in this directory. Minnesota: Anoka, Becker, Beltrami, Benton, Carver, Cass, Chisago, Clay, Clearwater, Crow Wing, Dakota, Douglas, Grant, Hennepin, Hubbard, Isanti, Kandiyohi, Mahnomen, Morrison, Norman, Otter Tail, Pope, Ramsey, Scott, Sherburne, Stearns, Todd, Wadena, Washington, Wilkin, and Wright. This directory is also for Medica Group Advantage Solution (PPO) in the counties listed below. You may go to any of our network providers listed in this directory. Minnesota: Anoka, Becker, Beltrami, Benton, Big Stone, Blue Earth, Brown, Carver, Cass, Chippewa, Chisago, Clay, Clearwater, Cottonwood, Crow Wing, Dakota, Dodge, Douglas, Faribault, Fillmore, Freeborn, Grant, Hennepin, Houston, Hubbard, Isanti, Jackson, Kandiyohi, Kittson, Lac qui Parle, Lake of the Woods, Lincoln, Lyon, Mahnomen, Marshall, Martin, Morrison, Mower, Murray, Nicollet, Nobles, Norman, Olmsted, Otter Tail, Pennington, Polk, Pope, Ramsey, Red Lake, Redwood, Renville, Roseau, Scott, Sherburne, Stearns, Steele, Swift, Todd, Wabasha,Wadena,Waseca, Washington, Watonwan, Wilkin, Winona and Wright. Medica Group Advantage Solution service area also includes most counties throughout the United States and its territories. Please call toll-free 1-866-269-6804, (TTY 711) to verify if you live in an eligible county not listed in this document and need assistance finding a provider in your area. To access Medica Advantage Solution’s online provider directory, you can visit Medica.com/AdvantageSolutionProviders. For any questions about the information contained in this directory (hardcopy or online), please call our Medica Customer Service department at 1-866-269-6804, 8 a.m. to 8 p.m. Central, seven days a week. TTY users should call 711. Medica Customer Service has free language interpreter services available for non-English speakers. Please call Medica Customer Service if you need plan information in another format. This information may be available in braille, in large print or other alternate formats. Please call Medica Customer Service if you need plan information in another format (phone numbers are printed on the back cover of this booklet). Introduction This directory provides a list of Medica Advantage Solution (HMO-POS), Medica Advantage Solution (PPO) and Medica Group Advantage Solution (PPO) network providers. To get detailed information about your health care coverage, please see your Evidence of Coverage (EOC). The network providers listed in this directory have agreed to provide you with your health care services. You may go to any of our network providers listed in this directory. You can get all covered services on your own, without a referral. In many cases, you may also get covered services from out-of-network providers. Out-of-network providers are under no obligation to treat Medica Advantage Solution enrollees, except in emergencies. For a decision about whether we will cover an out-of-network service, we encourage you or your provider to ask us for a pre-service organization determination before you receive the service. Please call our Medica Customer Service Department at 1-866-269-6804, 8 a.m. to 8 p.m. Central, seven days a week. TTY users should call 711. You may also refer to your Evidence of Coverage (EOC) for more information, including the cost sharing that applies to out- of-network services. Medica Advantage Solution (PPO) & Medica Group Advantage Solution (PPO) The out-of-network benefits provide access to non-contracted, Medicare-participating providers that agree to accept your plan. For assistance finding an out-of-network provider outside of our service area, please call Medica Customer Service at the number on the back of this directory. Medicare Advantage Solution (HMO-POS) plans The Point-of-Service (POS) benefit provides access to non-contracted,
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